{"id":31581,"date":"2014-05-16T15:35:02","date_gmt":"2014-05-16T14:35:02","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=31581"},"modified":"2014-07-28T16:33:46","modified_gmt":"2014-07-28T15:33:46","slug":"neal-maskrey-do-doctors-need-to-understand-more-about-decision-making","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/05\/16\/neal-maskrey-do-doctors-need-to-understand-more-about-decision-making\/","title":{"rendered":"Neal Maskrey: Do doctors need to understand more about decision making?"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/03\/neil_maskrey.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-31253\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/03\/neil_maskrey-150x110.jpg\" alt=\"neil_maskrey\" width=\"150\" height=\"110\" \/><\/a>A few months before the 2004 UEFA European Football Championship, we moved to the sports mad north west of England, where you could taste the anticipation. St George\u2019s flags hung from houses, work rotas were switched to catch the live matches on TV, and we put on a street barbeque for England\u2019s first match. Bunting was dusted off, faces were painted (not just the children\u2019s), and England\u2014having led 1-0 for most of the match\u2014conceded twice to the French in injury time. Supporting the English football team is a metaphor for life: long periods of low grade misery punctuated by brief\u2014but only brief\u2014periods of happiness. It was still a great party.<\/p>\n<p>Ten years on and nobody is getting excited about England\u2019s chances in the World Cup in Rio in June. I once heard a consultant surgeon say \u201cGood luck, you\u2019re going to need it\u201d to a colleague who was changing into scrubs before failing to achieve an emergency repair of a ruptured aortic abdominal aneurysm. A shiver ran down my spine when the same words, in the same \u201c<a href=\"https:\/\/www.youtube.com\/watch?v=9EH1G4EwljM\">we\u2019re doomed<\/a>\u201d tone, were the conclusion of the manager of the Danish football team after playing England last month.<!--more--><\/p>\n<p>I&#8217;ve had more conversations about the appointment of psychologist Dr Steve Peters to work with the England players in the lead up to Rio than about the football itself. Dr Peters has an impressive CV in sports psychology, and <a href=\"http:\/\/www.chimpparadox.co.uk\/\">his book<\/a> majors on the irrational and impulsive being that inhabits our minds\u2014the Inner Chimp. There isn\u2019t space to do it justice here, but the core of the approach is that understanding our own emotions is the first step to managing them, and that with practice this leads to greater control, focus, and confidence.<\/p>\n<p>Psychobabble, isn\u2019t it? Where\u2019s the evidence? Well, our fast intuitive approach to decision making, along with the slower rational one, are described in 40 years of research into behavioural economics and cognitive psychology. <a href=\"http:\/\/www.theguardian.com\/science\/2014\/feb\/16\/daniel-kahneman-thinking-fast-and-slow-tributes\">Daniel Kahneman<\/a> and <a href=\"http:\/\/www.economist.com\/node\/13350892\">Herbert Simon<\/a> both won Nobel prizes for their work, which has revolutionised and energised the study of decision making behaviour. If there are a couple of Nobel prizes given for this, maybe we should pay it a little attention?<\/p>\n<p>There are a few of us medics who think we might have missed out on something important here. What doctors are all about is making decisions. It seems sensible that people who are expected to be able to make great decisions know a little about how they\u2014and others\u2014make them; yet few healthcare professionals get any formal insights into decision making. Mainly we just hope people catch on how to avoid the pitfalls by osmosis. Think about it (pun intended).<\/p>\n<p>The England and Liverpool captain Steven Gerrard certainly buys into the concept of <a href=\"http:\/\/en.wikipedia.org\/wiki\/Metacognition\">metacognition<\/a>. &#8220;He can&#8217;t help you do a Cruyff turn or a 40 yard pass better, but he can help you learn what goes off inside your head.\u201d Couldn\u2019t have put it better, my son. Anyone for a barbeque?<\/p>\n<p><em><strong>Neal Maskrey&#8217;s<\/strong> early career was as a GP before spending seven years as a medical manager and part time GP. After twelve years as a director of the National Prescribing Centre and programme director at NICE, he is now honorary professor of evidence-informed decision making at Keele University, and consultant clinical adviser in the Medicines and Prescribing Centre, NICE.<\/em><\/p>\n<p><em>Competing interests: I declare that I have read and understood the BMJ Group policy on declaration of interests and I hereby declare the following interests: Employed part time by the National Institute for Health and Care Excellence.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A few months before the 2004 UEFA European Football Championship, we moved to the sports mad north west of England, where you could taste the anticipation. St George\u2019s flags hung [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/05\/16\/neal-maskrey-do-doctors-need-to-understand-more-about-decision-making\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5753],"tags":[],"class_list":["post-31581","post","type-post","status-publish","format-standard","hentry","category-neal-maskrey"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Neal Maskrey: Do doctors need to understand more about decision making? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/05\/16\/neal-maskrey-do-doctors-need-to-understand-more-about-decision-making\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Neal Maskrey: Do doctors need to understand more about decision making? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"A few months before the 2004 UEFA European Football Championship, we moved to the sports mad north west of England, where you could taste the anticipation. 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